Department of Medical Oncology, Georges François Leclerc Center, Centre de Recherche INSERM 866, Faculté de Médecine, Dijon, France.
Anticancer Res. 2010 Oct;30(10):4317-23.
There is currently no standard of treatment for patients with hormone refractory prostate cancer (HRPC) after failure of docetaxel-based chemotherapy. The purpose of this study was to assess the anticancer activity and tolerance of metronomic cyclophosphamide prednisolone combination in this setting.
From 2005 to 2010, patients with HRPC who failed at least docetaxel-based chemotherapy were proposed metronomic cyclophosphamide-prednisolone regimen, and were prospectively registered. Twenty-three patients received 50 mg cyclophosphamide and 10 mg prednisolone per os daily until disease progression. Treatment tolerance and efficacy on PSA decrease and pain were studied.
Metronomic cyclophosphamide prednisolone was safe, well tolerated, and demonstrated interesting clinical activity, yielding a prostate specific antigen decrease by ≥50% in 26% of patients and decrease by ≥30% in 48% of patients, but also favorable palliative effects on pain in 43% of patients. The median progression-free survival was 6 months (95% CI: 4-8 months) and the median overall survival was 11 months (95% CI: 7-19 months).
For this patient population, low dose metronomic cyclophosphamide prednisolone might be a viable alternative. Its convenient oral administration, low cost, and lack of toxicity justify further studies alone, or in combination with other agents in HRPC patients.
对于多西紫杉醇化疗失败后的激素难治性前列腺癌（HRPC）患者，目前尚无标准的治疗方法。本研究旨在评估节拍式环磷酰胺泼尼松龙联合方案在这种情况下的抗肿瘤活性和耐受性。
2005 年至 2010 年，我们提出了对至少接受过基于多西紫杉醇化疗失败的 HRPC 患者采用节拍式环磷酰胺泼尼松龙方案，并对其进行前瞻性登记。23 例患者接受环磷酰胺 50 mg 和泼尼松龙 10 mg 每日口服，直至疾病进展。研究了治疗的耐受性和对 PSA 下降及疼痛的疗效。
节拍式环磷酰胺泼尼松龙方案安全、耐受良好，并具有有趣的临床活性，在 26%的患者中前列腺特异性抗原（PSA）下降≥50%，在 48%的患者中下降≥30%，同时对 43%的患者具有有利的姑息性止痛作用。无进展生存期的中位数为 6 个月（95%CI：4-8 个月），总生存期的中位数为 11 个月（95%CI：7-19 个月）。
对于这一患者群体，低剂量节拍式环磷酰胺泼尼松龙可能是一种可行的替代方案。其方便的口服给药、低费用和无毒性使其在 HRPC 患者中具有进一步研究的价值，无论是单独使用还是与其他药物联合使用。
